Protocol for the controlled reproduction of the edible frog Aubria subsigillata in aquaculture hatcheries in the Republic of Benin.

Context Aubria subsigillata is such a highly valued, edible species for the citizens of Benin that over exploitation has led to a rarefaction of wild populations. Aims The aim of captive breeding is to develop breeding protocols and farming practices for the species which will reduce hunting pressure on wild populations. Methods The methodology consisted of determining the concentration of ovulatory hormone and its method of injection into the breeding stock, followed by in vitro fertilisation of the unfertilised eggs of the females by the spermic urine of the males to determine the optimum injection method, hormone concentration for ovulation and sperm collections, and the development of in vitro fertilisation protocols using gametes obtained via the aforementioned methodologies. Key results Results indicated that 0.2IU/g concentration of gonadotropin-releasing hormone agonist administered intrafemorally enabled spontaneous release of spermic urine and ova in the breeding animals. The latency time between injection and collection of gametes was 13h in males and 27h in females at a temperature of 28.5°C. Females laid an average of 172 eggs weighing 1mg mass. Conclusions Aubria subsigillata is a frog that reproduces using stimuli (hormone), and in vitro fertilisation resulted in a high rate of fertilised eggs. Implications Artifical reproduction in A. subsigillata is carried out in five phases: (1) selection of mature broodstock; (2) hormonal injection; (3) gamete collection; (4) in vitro fertilisation; and (5) incubation. However, work should continue on improving the egg hatching rate.

Field testing of user-friendly perennial malaria chemoprevention packaging in Benin, Côte d'Ivoire and Mozambique.

BACKGROUND: Perennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages throughout the year. Sulfadoxine-pyrimethamine (SP) has been widely used for chemoprevention in Africa and a child-friendly dispersible tablet formulation has recently become available. METHODS: This qualitative non-interventional observational study was conducted in Benin, Côte d'Ivoire, and Mozambique between February and June 2022. Prototype blister packs, dispensing boxes and job aids designed to support dispersible SP deployment for PMC were evaluated using focus group discussions (FGD) and semi-structured in-depth individual interviews (IDI) with health authorities, health personnel, community health workers (CHWs) and caregivers. The aim was to evaluate knowledge and perceptions of malaria and chemoprevention, test understanding of the tools and identify gaps in understanding, satisfaction, user-friendliness and acceptability, and assess the potential role of CHWs in PMC implementation. Interviews were transcribed and imported to ATLAS.ti for encoding and categorization. Thematic content analysis used deductive and inductive coding with cross-referencing of findings between countries and participants to enrich data interpretation. Continuous comparison across the IDI and FGD permitted iterative, collaborative development of materials. RESULTS: Overall, 106 participants completed IDIs and 70 contributed to FGDs. Malaria was widely recognised as the most common disease affecting children, and PMC was viewed as a positive intervention to support child health. The role of CHWs was perceived differently by the target groups, with caregivers appreciating their trusted status in the community, whereas health authorities preferred clinic-based deployment of PMC by health professionals. Empirical testing of the prototype blister packs, dispensing boxes and job aids highlighted the context-specific expectations of respondents, such as familiar situations and equipment, and identified areas of confusion or low acceptance. A key finding was the need for a clear product identity reflecting malaria. CONCLUSION: Simple modifications profoundly affected the perception of PMC and influenced acceptability. Iterative quantitative investigation resulted in PMC-specific materials suited to the local context and socio-cultural norms of the target population with the aim of increasing access to chemoprevention in children most at risk of severe malaria.

Prognostic factors and overall survival of breast cancer in Benin: a hospital-based study.

BACKGROUND: In Benin, a country in West Africa, breast cancer is the leading cancer in women, both in terms of incidence and mortality. However, evidence on the mortality of breast cancer and its associated factors is lacking in this country. Our aim was to describe and analyze the clinical, histopathological, and prognostic aspects of breast cancer in Benin. METHODS: A descriptive and analytical study was carried out at the CNHU-HKM and the CHU-MEL, two major tertiary referral hospitals for breast cancer management located in Cotonou, the capital city of Benin. All breast cancer medical records with histological evidence and immunohistochemistry studies were retrospectively collected between January 1, 2014, and September 30, 2020, in these two tertiary referral hospitals and analyzed in the current study. RESULTS: Finally, 319 medical records were included. The mean age at diagnosis was 48.74 years. The tumors were most frequently classified as T4 (47.6%) with lymph node involvement N2 (34.5%), and metastases were clinically noted in 21.9% of cases. Stage was reported in the medical records of 284 patients. Tumors were diagnosed at very late AJCC stages: stage III (47.5%) and stage IV (24.7%). Grades SBR 2 (49.2%) and SBR 3 (32.6%) were the most frequent grades. Triple-negative breast cancer (31.3%) was the most common molecular type. The overall 5-year survival was 48.49%. In multivariable analysis, the poor prognostic factors were lymph node invasion (HR = 2.63; p = 0.026; CI: [1.12, 6.17]), the presence of metastasis (HR = 3.64; p < 0.001); CI: [2.36, 5.62] and the immunohistochemical profile (HR = 1.29; p < 0.001; CI: [1.13, 1.48]). CONCLUSIONS: Breast cancer in Beninese is predominant in young adults and is often diagnosed at a late stage. The survival of breast cancer patients in Benin can be improved by enhancing early diagnosis and multidisciplinary management.

Advanced in immunological monitoring of HIV infection: profile of immune cells and cytokines in people living with HIV-1 in Benin.

BACKGROUND: Immune cells and cytokines have been linked to viremia dynamic and immune status during HIV infection. They may serve as useful biomarkers in the monitoring of people living with HIV-1 (PLHIV-1). The present work was aimed to assess whether cytokines and immune cell profiles may help in the therapeutic follow-up of PLHIV-1. METHODS: Forty PLHIV-1 in treatment success (PLHIV-1s) and fifty PLHIV-1 in treatment failure (PLHIV-1f) followed at the University Hospital of Abomey-Calavi/Sô-Ava in Benin were enrolled. Twenty healthy persons were also recruited as control group. Circulating cytokines and immune cells were quantified respectively by ELISA and flow cytometry. RESULTS: PLHIV-1 exhibited low proportions of CD4 + T cells, NK, NKT, granulocytes, classical and non-classical monocytes, and high proportions of CD8 + T cells, particularly in the PLHIV-1f group, compared to control subjects. Eosinophils, neutrophils and B cell frequencies did not change between the study groups. Circulating IFN-γ decreased whereas IL-4 significantly increased in PLHIV-1s compared to PLHIV-1f and control subjects even though the HIV infection in PLHIV-1s downregulated the high Th1 phenotype observed in control subjects. However, Th1/Th2 ratio remained biased to a Th1 phenotype in PLHIV-1f, suggesting that high viral load may have maintained a potential pro-inflammatory status in these patients. Data on inflammatory cytokines showed that IL-6 and TNF-α concentrations were significantly higher in PLHIV-1s and PLHIV-1f groups than in control subjects. Significant high levels of IL-5 and IL-7 were observed in PLHIV-1f compared to controls whereas PLHIV-1s presented only a high level of IL-5. No change was observed in IL-13 levels between the study groups. CONCLUSION: Our study shows that, in addition to CD4/CD8 T cell ratio, NK and NKT cells along with IL-6, TNF-α, IL-5 and IL-7 cytokines could serve as valuable immunological biomarkers in the therapeutic monitoring of PLHIV-1 although a larger number of patients would be necessary to confirm these results.

Transcriptomic analysis of Anopheles gambiae from Benin reveals overexpression of salivary and cuticular proteins associated with cross-resistance to pyrethroids and organophosphates.

BACKGROUND: Insecticide resistance (IR) is one of the major threats to malaria vector control programs in endemic countries. However, the mechanisms underlying IR are poorly understood. Thus, investigating gene expression patterns related to IR can offer important insights into the molecular basis of IR in mosquitoes. In this study, RNA-Seq was used to characterize gene expression in Anopheles gambiae surviving exposure to pyrethroids (deltamethrin, alphacypermethrin) and an organophosphate (pirimiphos-methyl). RESULTS: Larvae of An. gambiae s.s. collected from Bassila and Djougou in Benin were reared to adulthood and phenotyped for IR using a modified CDC intensity bottle bioassay. The results showed that mosquitoes from Djougou were more resistant to pyrethroids (5X deltamethrin: 51.7% mortality; 2X alphacypermethrin: 47.4%) than Bassila (1X deltamethrin: 70.7%; 1X alphacypermethrin: 77.7%), while the latter were more resistant to pirimiphos-methyl (1.5X: 48.3% in Bassila and 1X: 21.5% in Djougou). RNA-seq was then conducted on resistant mosquitoes, non-exposed mosquitoes from the same locations and the laboratory-susceptible An. gambiae s.s. Kisumu strain. The results showed overexpression of detoxification genes, including cytochrome P450s (CYP12F2, CYP12F3, CYP4H15, CYP4H17, CYP6Z3, CYP9K1, CYP4G16, and CYP4D17), carboxylesterase genes (COEJHE5E, COE22933) and glutathione S-transferases (GSTE2 and GSTMS3) in all three resistant mosquito groups analyzed. Genes encoding cuticular proteins (CPR130, CPR10, CPR15, CPR16, CPR127, CPAP3-C, CPAP3-B, and CPR76) were also overexpressed in all the resistant groups, indicating their potential role in cross resistance in An. gambiae. Salivary gland protein genes related to 'salivary cysteine-rich peptide' and 'salivary secreted mucin 3' were also over-expressed and shared across all resistant groups. CONCLUSION: Our results suggest that in addition to metabolic enzymes, cuticular and salivary gland proteins could play an important role in cross-resistance to multiple classes of insecticides in Benin. These genes warrant further investigation to validate their functional role in An. gambiae resistance to insecticides.

Implementation of post-discharge malaria chemoprevention (PDMC) in Benin, Kenya, Malawi, and Uganda: stakeholder engagement meeting report.

A Stakeholder engagement meeting on the implementation of post-discharge malaria chemoprevention (PDMC) in Benin, Kenya, Malawi, and Uganda was held in Nairobi, Kenya, on 27 September 2023. Representatives from the respective National Malaria Control Programmes, the World Health Organization (WHO) Geneva, Africa Regional and Kenya offices, research partners, non-governmental organizations, and the Medicines for Malaria Venture participated. PDMC was recommended by the WHO in June 2022 and involves provision of a full anti-malarial treatment course at regular intervals during the post-discharge period in children hospitalized with severe anaemia in areas of moderate-to-high malaria transmission. The WHO recommendation followed evidence from a meta-analysis of three clinical trials and from acceptability, delivery, cost-effectiveness, and modelling studies. The trials were conducted in The Gambia using monthly sulfadoxine-pyrimethamine during the transmission season, in Malawi using monthly artemether-lumefantrine, and in Kenya and Uganda using monthly dihydroartemisinin-piperaquine, showing a significant reduction in all-cause mortality by 77% (95% CI 30-98) and a 55% (95% CI 44-64) reduction in all-cause hospital readmissions 6 months post-discharge. The recommendation has not yet been implemented in sub-Saharan Africa. There is no established platform for PDMC delivery. The objectives of the meeting were for the participating countries to share country contexts, plans and experiences regarding the adoption and implementation of PDMC and to explore potential delivery platforms in each setting. The meeting served as the beginning of stakeholder engagement within the PDMC Saves Lives project and will be followed by formative and implementation research to evaluate alternative delivery strategies in selected countries. Meeting highlights included country consensus on use of dihydroartemisinin-piperaquine for PDMC and expansion of the target group to "severe anaemia or severe malaria", in addition to identifying country-specific options for PDMC delivery for evaluation in implementation research. Further exploration is needed on whether the age group should be extended to school-age children.

Chapitre 3. Inégalités dans le dépistage et la prévention du VIH/SIDA.

Despite progress in the detection and treatment of the Human Immunodeficiency Virus (HIV), major challenges remain in developing countries due to insufficient resources and infrastructure. The number of people living with HIV who do not know their serostatus has fallen worldwide. However, a number of existing obstacles stand in the way of better results. The socio-cultural context in Africa hampers knowledge and understanding of the disease, leading to stigmatizing attitudes, reluctance to undergo screening and poor access to treatment.Inequalities also exist within the countries of the North, as in the case of the French West Indies, which benefit from a policy to combat HIV/AIDS, with results that fall short of those in mainland France. For this reason, we have chosen to compare the situation in the West Indies with that in Benin, in the context of African culture.Our analysis takes stock of the issues and prospects linked to the accessibility and use of screening care in sub-Saharan Africa and the French Departments of America (DFA).In both cases, fear of the disease, stigmatization, fear of a positive HIV test result and fear of disclosing the test result limit preventive and treatment actions for an effective fight against HIV.In sub-Saharan Africa, women are more likely to accept a screening test than men. Certain populations, including adolescents and homosexuals, are in a vulnerable position. The comparison reveals similar attitudes and suggests actions or recommendations in both countries that have produced results.Innovative strategies and specific programs must be implemented to turn the tide in the fight against the HIV epidemic.

"Our desire is to make this village intestinal worm free": Identifying determinants of high coverage of community-wide mass drug administration for soil transmitted helminths in Benin, India, and Malawi.

BACKGROUND: Soil-transmitted helminth infections (STH) are associated with substantial morbidity in low-and-middle-income countries, accounting for 2.7 million disability-adjusted life years annually. Current World Health Organization guidelines recommend controlling STH-associated morbidity through periodic deworming of at-risk populations, including children and women of reproductive age (15-49 years). However, there is increasing interest in community-wide mass drug administration (cMDA) which includes deworming adults who serve as infection reservoirs as a method to improve coverage and possibly to interrupt STH transmission. We investigated determinants of cMDA coverage by comparing high-coverage clusters (HCCs) and low-coverage clusters (LCCs) receiving STH cMDA in three countries. METHODS: A convergent mixed-methods design was used to analyze data from HCCs and LCCs in DeWorm3 trial sites in Benin, India, and Malawi following three rounds of cMDA. Qualitative data were collected via 48 community-level focus group discussions. Quantitative data were collected via routine activities nested within the DeWorm3 trial, including annual censuses and coverage surveys. The Consolidated Framework for Implementation Research (CFIR) guided coding, theme development and a rating process to determine the influence of each CFIR construct on cMDA coverage. RESULTS: Of 23 CFIR constructs evaluated, we identified 11 constructs that differentiated between HCCs and LCCs, indicating they are potential drivers of coverage. Determinants differentiating HCC and LCC include participant experiences with previous community-wide programs, communities' perceptions of directly observed therapy (DOT), perceptions about the treatment uptake behaviors of neighbors, and women's agency to make household-level treatment decisions. CONCLUSION: The convergent mixed-methods study identified barriers and facilitators that may be useful to NTD programs to improve cMDA implementation for STH, increase treatment coverage, and contribute to the successful control or elimination of STH. TRIAL REGISTRATION: The parent trial was registered at clinicaltrials.gov (NCT03014167).

Epidemiology of Childhood Fractures in Cotonou: A Retrospective Observational Study.

BACKGROUND: Childhood fractures are frequent. The aim of this study was to evaluate their epidemiological and clinical peculiarities in our context. MATERIALS AND METHODS: This was a retrospective study that focused on the files of children with a fracture. They were aged 0-15 years and received between January 2011 and December 2015 at the Emergency Department of the National Teaching Hospital of Cotonou. RESULTS: Two hundred and eighty fractures were recorded in 257 children. The average age was 8.24 years (7 days-15 years). Older children (6-10 years) were the most affected with 33.8% of cases. The predominance was male (sex ratio = 2.3:1). The aetiologies were dominated by road traffic accidents (45.1%) followed by domestic accidents (42.7%). Fractures were predominant in the lower limbs (52.1%). The most affected segments were the leg (25.4%) and the femur (23.6%). The fracture was open in 13.9% of cases. CONCLUSION: Childhood fractures interest preferentially the older boys. Then, road traffic accidents are the most frequent circumstances of occurrence in our context. Measures to prevent the main causes of these fractures must be taken, in order to reduce their frequency and ensure the development of children.

Nexus between prevalence of Taenia solium (Cysticercus cellulosae) in pigs and retrospective study of humans cysticercosis cases in Benin hospitals.

The cysticercosis is a major zoonotic disease in many developing countries. This study was carried out to determine the prevalence of porcine cysticercosis and to identify potential risk factors associated and their seroprevalence as well in Benin. The tongue palpation was performed on 4150 pigs from the pig farmers were randomly selected to diagnose cysticercosis and to assess the risk factors associated. In slaughterhouses, 792 pigs were inspected. Serum samples from 460 pigs were tested of the presence of Taenia solium cysticercosis using the HP10 antigen-ELISA (Ag-ELISA). A logistic regression model with a 95% confidence interval was used to analyse the main risk factors associated. The tongue palpation revealed a prevalence of 4.79% at the level of slaughterhouses versus 7.82% in the post-mortem inspection. The Ag-ELISA revealed that more than 40% of the pigs were positive. The risk factors identified were the origin area of pigs, the history of cysticercosis in the farms, the presence or absence of a latrine, the pig-farming systems, the age class of pigs and the source of watering. In addition, 34.48% individuals was tested for taenia versus 13.79% for cysticercosis in the hospitals surveyed. Our results showed the major revelation of porcine cysticercosis and its very high level of risk for a public health in all departments of Benin. Therefore, this study suggests the need to continue epidemiological and sociological surveys with a "One Health" approach in order to design and implement effective control measures in this country of high consumption of pigs.

Prevalence and determinants of high-risk human papilloma virus among men who have sex with men in Benin: a cross-sectional study embedded in a demonstration project on pre-exposure prophylaxis against HIV.

OBJECTIVES: This study aims to assess the prevalence and factors associated with anal high-risk human papilloma virus (HR-HPV). DESIGN: A cross-sectional study conducted from 24 August 2020 to 24 November 2020. SETTING: Primary care, Cotonou, Benin. PARTICIPANTS: 204 HIV-negative men who have sex with men initiating oral pre-exposure prophylaxis. PRIMARY OUTCOME MEASURE: Anal HR-HPV genotypes using GeneXpert HPV assay. Fourteen HR-HPV were evaluated: HPV-16 and HPV-18/45 in 2 distinct channels and the 11 other genotypes as a pooled result (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68). The potential independent variables analysed included anal gonorrhoea and chlamydia infections, and sociodemographic and sexual behaviour factors. To assess the determinants of HR-HPV, univariate and multivariate Poisson regression models were performed by using SAS V.9.4. RESULTS: Mean age±SD was 25.9±4.8 years. 131/204 men claimed insertive sex procured more pleasure. Thirty-two participants, accounting for 15.7% of the study sample, had gonorrhoea and/or chlamydia. The prevalence of any HR-HPV genotype was 36.3% (95% CI 30.0% to 43.0%). In total, 7.8% of men had HPV-16 and 7.4% had HPV-18/45. The prevalence for the pooled genotypes (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68) was 29.9%. Receptive anal sex during the last 6 months was strongly associated with prevalent HR-HPV infections. The adjusted proportion ratio (aPR) was 1.93 (95% CI 1.31 to 2.83). Gonorrhoea and chlamydia were also associated with the outcome of interest; p value for both infections was <0.05. The aPR comparing patients who perceived some risk of acquiring HIV to other men was 1.44 (95% CI 1.00 to 2.08). CONCLUSIONS: In Benin, anal HR-HPV was common among HIV-negative men who have sex with men. Among this highly vulnerable population, there is a need for integrated preventive and management strategies targeting HPV and other sexually transmitted infections.

Durability of the deltamethrin-treated polypropylene long-lasting net LifeNet® in a pyrethroid resistance area in south western Benin: A phase III trial.

BACKGROUND: Long-lasting insecticidal bed nets (LLINs) are a key measure for preventing malaria and their evaluation is coordinated by the World Health Organization Pesticide Evaluation Scheme (WHOPES). LifeNet® was granted WHOPES time-limited interim recommendation in 2011 after successful Phase I and Phase II evaluations. Here, we evaluated the durability and community acceptance of LifeNet® in a Phase III trial from June 2014 to June 2017 in Benin rural area. METHODS: A prospective longitudinal, cluster-randomized, controlled trial with households as the unit of observation was designed to assess the performance of LifeNet® over a three-year period, using a WHOPES fully recommended LLIN (PermaNet® 2.0) as a positive control. The primary outcomes were the bioassay performance using WHO cone assays and tunnel tests, the insecticide content and physical integrity. RESULTS: At baseline, 100% of LLINs were within the tolerance limits of their target deltamethrin concentrations. By 36 months only 17.3% of LifeNet® and 8.5% of PermaNet® LLINs still were within their target deltamethrin concentrations. Despite these low rates, 100% of both LLINs meet WHO efficacy criteria (≥ 80% mortality or ≥ 95% knockdown or tunnel test criteria of ≥ 80% mortality or ≥ 90% blood-feeding inhibition) after 36 months using WHO cone bio-assays and tunnel tests. The proportion of LLINs in good physical condition was 33% for LifeNet® and 29% for PermaNet® after 36 months. After 36 M the survivorship was 21% and 26% for LifeNet® and PermaNet® respectively. Although both LLINs were well accepted by the population, complaints of side effects were significantly higher among LifeNet® users than PermaNet® ones. CONCLUSION: LifeNet® LLINs did meet WHO criteria for bio-efficacy throughout the study period and were well accepted by the population. This is an important step towards getting a full WHO recommendation for use in malaria endemic countries.

Prevalence and factors associated with undernutrition among children under the age of five years in Benin.

BACKGROUND: Benin ranks as one of the countries in the world with an alarmingly high prevalence of stunting, wasting, and underweight in children under five years. However, limited studies have examined the factors associated with the prevalence of these undernutrition indicators among children under five years in the country. This study aimed to fill this research gap by examining the prevalence rates and factors associated with stunting, wasting, and underweight among this specific population of interest. METHODS: This quantitative study utilised data from the most recent Benin Demographic and Health Survey (BDHS) conducted in 2017-18. The survey employed a nationally representative cross-sectional design and utilised a two-stage stratified cluster sampling technique to select participants. The study included a sample of 13,589 children under the age of five years. The main analytical approach employed was binary logistic regression, which was used to explore the associations between undernutrition (the combined outcome variable representing stunting, wasting, and underweight) and various socio-demographic factors. RESULTS: The combined prevalence of stunting, wasting, and underweight among children under five years in Benin during the 2017-18 survey period was 14.95%. Several factors were significantly associated with these indicators of undernutrition, including female gender (AOR = 0.71, 95% CI = 0.59-0.85), birth weight of 4.1 kg and over (AOR = 0.26, 95% CI = 0.14-0.48), multiple births (AOR = 3.22, 95% CI = 2.11-4.91), and a child's experience of diarrhoea (AOR = 1.76, 95% CI = 1.40-2.20). Furthermore, the prevalence of these undernutrition indicators was higher among children whose mothers had lower levels of education (AOR = 0.82, 95% CI = 0.01-0.42) and were unmarried (AOR = 0.67, 95% CI = 0.49-0.93). CONCLUSIONS: This present study confirms that undernutrition rates are elevated in Benin and are closely linked to perinatal factors such as birth weights and multiple births, postnatal health conditions including diarrheal episodes, and socio-demographic determinants such as a child's gender, maternal education level, and marital status. Therefore, there is the need to consider specific modifiable factors, such as low birth weight, episodes of child diarrhoea, and maternal education as priority targets for child nutrition interventions in Benin.

Antioxidant, Anti-Inflammatory, and Anti-Cancer Properties of Amygdalin Extracted from Three Cassava Varieties Cultivated in Benin.

Given that cancer is a disease that is rampant in the world and especially in Africa, where the population has enormous difficulty treating it, plants are a safer and less expensive alternative. Cassava is a plant species valued in Benin because of its numerous medicinal and nutritional virtues. This study evaluated the biological activities of amygdalin from the organs of three cassava varieties most commonly produced in Benin (BEN, RB, and MJ). HPLC analysis was used to quantify amygdalin in cassava organs and derivatives. Phytochemical screening was performed to determine secondary metabolite groups. DPPH and FRAP methods were used to assess antioxidant activity. Cytotoxicity of the extracts was tested on Artemia salina larvae. The anti-inflammatory activity was evaluated in vivo in an albino mouse paw edema model induced by 5% formalin. The anticancer activity was evaluated in vivo on Wistar rats rendered cancerous by 1,2-dimethylhydrazine (DMH) using 5-fluorouracil as a reference molecule. The results showed that the organs of all three-cassava varieties contained glycosides, flavonoids, saponosides, steroids, tannins, coumarins, and cyanogenic derivatives. Young stems and fresh cassava leaves had the highest amygdalin concentrations, with 11,142.99 µg 10 g-1 and 9251.14 µg 10 g-1, respectively. The Agbeli derivative was more concentrated in amygdalin, with a content of 401.56 µg 10 g-1 than the other derivatives. The antioxidant activity results showed that the amygdalin extracts were DPPH radical scavengers with IC50 values ranging from 0.18 mg mL-1 to 2.35 mg mL-1. The cytotoxicity test showed no toxicity of the extracts toward shrimp larvae. Administration of amygdalin extracts from the leaves of BEN and MJ varieties prevents inflammatory edema. The percentages of edema inhibition varied between 21.77% and 27.89%. These values are similar (p > 0.05) to those of acetylsalicylic acid (25.20%). Amygdalin extract of the BEN variety significantly (p < 0.0001) reduces edema. Both BEN extracts inhibited cancer induction with DMH. In preventive and curative treatments, rats fed with amygdalin extracts showed low anti-cancer activity under the effect of DMH and a significant difference in biochemical results. Thus, the organs of all three cassava varieties studied have secondary metabolites and good antioxidant activity. The leaves contain high levels of amygdalin and can be used as anti-inflammatory and anticancer agents.

An Overview of 10 Years of Activity of a Molecular Laboratory for Buruli Ulcer Diagnosis at a Field Hospital in Benin.

Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans. Early diagnosis is crucial to prevent morbidity. In November 2012, a field laboratory fully equipped for the rapid on-site quantitative PCR (qPCR) diagnosis of M. ulcerans was established at the Buruli ulcer treatment center (CDTLUB) center in Pobè Benin, a region where BU is endemic. We describe its first 10 years of activity and its gradual evolution into an expert laboratory for BU diagnosis. From 2012 to 2022, the laboratory analyzed 3,018 samples from patients attending consultations for suspected BU at the CDTLUB in Pobè. Ziehl-Neelsen staining and qPCR targeting the IS2404 sequence were performed. Since 2019, the laboratory has also received and analyzed 570 samples from other centers. The laboratory confirmed the diagnosis of BU by qPCR for 39.7% samples: M. ulcerans DNA was detected in 34.7% of swabs, 47.2% of all fine needle aspiration samples (FNA) and 44.6% of all skin biopsy specimens. Positive Ziehl-Neelsen staining results were obtained for 19.0% samples. Bacterial load, estimated by qPCR, was significantly greater for the Ziehl-Neelsen-positive samples than for Ziehl-Neelsen-negative samples, and detection rates were highest for FNA samples. Overall, 26.3% of the samples received from other centers were positive for BU. Most of these samples were sent by the CDTLUBs of Lalo, Allada, and Zagnanado, Benin. The establishment of the laboratory in the CDTLUB of Pobè has been a huge success. Optimal patient care depends on the close proximity of a molecular biology structure to BU treatment centers. Finally, FNA should be promoted among caregivers. IMPORTANCE Here, we describe the first 10 years of activity at a field laboratory established at the Buruli ulcer treatment center (CDTLUB) in Pobè, Benin, a country in which Mycobacterium ulcerans is endemic. Between 2012 and 2022, the laboratory analyzed 3,018 samples from patients consulting the CDTLUB of Pobè with a suspected clinical BU. Ziehl-Neelsen staining and qPCR targeting the IS2404 sequence were performed. In total, 39.7% of samples tested positive by qPCR and 19.0% tested positive by Ziehl-Neelsen staining. Detection rates were highest for FNA samples, and the bacterial loads estimated by qPCR were significantly higher for Ziehl-Neelsen-positive samples than for Ziehl-Neelsen-negative samples. Since 2019, the laboratory has also analyzed 570 samples received from outside the CDTLUB of Pobè, 26.3% of which were positive for BU. Most of these samples were sent by the CDTLUBs of Lalo, Allada, and Zagnanado in Benin. The establishment of the laboratory in the CDTLUB of Pobè has been a huge success, with major benefits for both the medical staff and patients. Our findings illustrate that the usefulness and feasibility of having a diagnostic center in rural Africa, where the disease is endemic, is a key part of optimal patient care, and that FNA should be promoted to increase detection rates.

HIV testing and counselling among women in Benin: a cross-sectional analysis of prevalence and predictors from demographic and health survey data.

OBJECTIVE: To examine the uptake of HIV testing and counselling (HTC) and its associated factors among women in Benin. DESIGN: We performed a cross-sectional analysis of data from the 2017-2018 Benin Demographic and Health Survey. A weighted sample of 5517 women was included in the study. We used percentages to present the results of the uptake of HTC. Multilevel binary logistic regression analysis was used to examine the predictors of HTC uptake. The results were presented using adjusted odds ratios (aORs), with 95% confidence intervals (CIs). SETTING: Benin. PARTICIPANTS: Women aged 15-49. OUTCOME MEASURE: Uptake of HTC. RESULTS: The overall uptake of HTC among women in Benin was found to be 46.4% (44.4%-48.4%). The odds of HTC uptake was higher among women covered by health insurance (aOR 3.04, 95% CI 1.44 to 6.43) and those with comprehensive HIV knowledge (aOR 1.77, 95% CI 1.43 to 2.21). The odds of HTC uptake increased with increasing level of education, with the highest odds among those in the secondary or higher level (aOR 2.06, 95% CI 1.64 to 2.61). Also, the age of the women, mass media exposure, region of residence, high community literacy level, and high community socioeconomic status were associated with higher odds of HTC uptake. Women residing in rural areas were less likely to use HTC. Religious affiliation, number of sexual partners, and place of residence were associated with lower odds of HTC uptake. CONCLUSION: Our study has shown that the uptake of HTC among women in Benin is relatively low. There is a need to enhance efforts to empower women, as well as reduce health inequities as they all have a substantial impact on HTC uptake among women in Benin, taking into consideration the factors identified in this study.

Sources, pollution, and ecological risk assessment of polycyclic aromatic hydrocarbons (PAHs) in Porto-Novo Lagoon, Benin Republic.

The Porto-Novo Lagoon is influenced by agricultural discharges and human activities. In order to evaluate the impact of wastes and human activities on Porto-Novo Lagoon, the sources and ecological risks of sixteen polycyclic aromatic hydrocarbons (PAHs) were assessed. The physicochemical and biological parameters of the water were also determined. The result showed that between the sampling sites, the mean concentration of dissolved oxygen ranged from 4.8 ± 0.5 to 5.1 ± 0.2 mg/L; biochemical oxygen demand varied from 12.6 ± 2.0 to 77.9 ± 81.9 mg/L; biological oxygen demand ranged from 2.8 ± 2.6 to 5.6 ± 0.9 mg/L; total phosphorus varied between 4.7 ± 2.7 and 15.3 ± 9.5 mg/L; total dissolved solids ranged from 183.0 ± 115.8 to 337.5 ± 413.3 mg/L, and Escherichia coli varied from 495.0 ± 542.9 to 1920.0 ± 2676.5 UFC/100 mL. Water parameter values obtained were not within World Health Organization (WHO)-recommended limits except pH and TDS. Total PAHs (∑PAHs) concentration varied from 38.8 to 123.9 mg/L. The mean ∑PAH concentration was 83.2 ± 20.3 mg/L. Benzo[b]fluoranthene, benzo[g,h,i]perylene, and benzo[k]fluoranthene were the most dominant PAHs and contributed to 55.9%, 15.3%, and 4.5% of the ∑PAHs concentration, respectively. Douane-Tokpa and Djassin recorded the lowest and highest concentrations. PAHs of four to six rings were the most abundant across the sampling sites. Naphthalene showed the lowest risk in the lagoon. Acenaphthene showed low risk at Djassin, while Indeno(1,2,3 cd)pyrene showed low risk at Benin Industry Body Fat. Except for those that were not detected, all the PAHs at individual or complex mixture levels showed high risk at all the sites. The highest total concentration was recorded in Djassin followed by Beaurivage. The high level of PAHs pollution was attributed to both human and goods traffic, runoff, and the complex hotels close to the lagoon. Molecular diagnostic ratios and principal component analysis suggest that the target hydrocarbons were from both petrogenic and pyrogenic sources with predomination of vehicular emission and coal/woods combustion. ∑LWM/HWM confirmed also the predominance of pyrolytic sources of PAHs in Porto-Novo Lagoon. The predominance of the vehicular emission may be due to the position of the complex Porto-Novo Lagoon-Nokoué Lake which is between the two big cities of the country.

[Adequacy of histopathology request forms and pathological reports of breast cancer surgical specimens in Benin]. / Conformité des formulaires de demande et des comptes rendus anatomopathologiques de pièces opératoires de cancer du sein au Bénin.

Introduction: Breast cancer requires multidisciplinary management. Pathologists and physicians communicate using the histopathology request form and the pathology report. There are some minimal criteria that both should respect. Objective: We assessed the adequacy of histopathology request forms and pathology reports in the management of female breast cancer specimens in Southern Benin. Method: This was a cross-sectional, descriptive and analytical study, with retrospective data collection over 57 months (4 years and 9 months). The adequacy of the histopathology request forms and pathology reports was assessed on the basis of the recommendations of the Haute Autorité de Santé (HAS) of France. Data processing was done using SPSS software. We checked frequencies with the Chi2 test, with a significance level set at 5%. Results: 31.3% of histopathology request forms complied with HAS recommendations. Pathology reports were presented in a narrative way in 92.7% of cases and 68.8% met the minimal criteria. The presence of vascular embolus, of hormone receptors and the HER2 status were all reported in only 29.2% of the reports. Discussion: The draft of histopathology request forms and pathology reports did not comply to the required minimal criteria. This situation could mainly be explained by the inexistence of consensus between physicians and pathologists and by the lack of immunohistochemistry. Editing national referentials and using synoptic reports would give better results.

Challenge of gastro-intestinal stromal tumor management in low-income countries: example of Benin.

BACKGROUND: GISTs are rare tumors but the most frequent mesenchymal tumors of the digestive tract. Diagnosis and treatment are challenging in low-income countries due to relatively poor access to immunohistochemistry and targeted therapy. In Africa, there are few studies about it. Imatinib, an oral targeted therapy, has been available in Benin since 2010 and free since 2016. This study describes the diagnosis and therapeutic management of GIST in Cotonou, Benin. METHODS: This is a descriptive cross-sectional study, with retrospective data collection over a 10-year period from 2010 to 2020, focused on patients with histological confirmed gastro-intestinal stromal tumor (GIST). Cases were identified using the registry database and the archival files of the Hubert Koutoukou Maga National University Hospital of Cotonou (CNHU-HKM). RESULTS: Fifteen GISTs were identified during the study period. The median age was 52 and the sex ratio was 2:1 (10 males and 5 females). The most frequent symptom was abdominal pain (n = 12). Delay in care seeking after onset of symptoms ranged from 24 h to 15 years. The most common site for GISTs was the stomach (n = 8). The median tumor size was 11 cm and the majority (n=10) was metastatic or locally advanced at the time of diagnosis. The tumors were often spindle-shaped at histology (n = 13) and the majority expressed KIT (n = 14). Most of the tumors (n = 12) were at high risk of recurrence according to the Joensuu scoring system. The availability of imatinib has improved the outcome of GIST with response in all cases it was used in neoadjuvant setting (n = 7). CONCLUSION: GISTs are rare tumors and preferentially affect the stomach in Cotonou). Most of the tumors were large, unresectable at the time of diagnosis and at high risk of recurrence. Access to imatinib has revolutionized the management of those tumors in our country.

Diagnostic capabilities of self-reported psychoactive substance use among patients admitted to psychiatric consultations in Benin, West Africa.

BACKGROUND: There is a high prevalence of psychoactive substance use among patients with mental health disorders. The optimal treatment of patients with mental health disorders requires an awareness of their history pertaining substance use. Several methods are used to assess the use of substance. Each of them embodies its limitations. This study aimed at assessing the diagnostic capability of a self-report psychoactive substance use among patients at the National Psychiatric University Hospital of Cotonou, Benin. METHODS: A cross-sectional survey was conducted from August 1, 2021 to November 24, 2021. A total of 157 consenting patients admitted to psychiatric consultations were successively enrolled in the ongoing study. They were screened for the use of psychoactive substance with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), followed by urine test using the NarcoCheck® kit for qualitative detection of substances or its metabolites. To assess the diagnostic capability, the participants' self-responses were compared with their urine test results. The sensitivity, specificity, positive and negative predictive values, and kappa coefficient were also calculated. RESULTS: The frequency of lifetime psychoactive substance use according to self-report was 81.5% (95% CI: 0.746-0.873), while over the past three months (recent use) was 52.2% (95% CI: 0.441-0.603) and 58.6% based on the urine test. Alcohol, tobacco and cannabis were the most prevalent psychoactive substance used. The overall concordance between self-reported psychoactive substance use and the urine test (gold standard) was moderate (sensitivity = 66%; kappa = 0.46). Self-report cocaine use compared with urine test showed the highest concordance (sensitivity = 100%; kappa = 79%), followed by tobacco (sensitivity = 58%, kappa = 41%). On an average 70% of urine test results were consistent with self-report (VPP). Participants' were more accurate when they were reporting no psychoactive substance use as suggested by the high negative predictive value (NPV). CONCLUSION: Diagnostic capability of self-reporting of psychoactive substance use among patients admitted to psychiatric consultations was moderate. Therefore self-reporting may not estimate the exact prevalence of psychoactive substance use. Optimal identification of psychoactive substances use in psychiatric patients requires both history and urine testing. The integration of these two approaches is an excellent method to find out the level, frequency and nature of drug used.